| NPI | 1629041587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: DC MD20791) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: VA 0101055200) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MS 07657) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2007-07-08 |