| NPI | 1619108354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 78736) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME127101) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: GA 78736) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 78736) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2023-03-10 |