| NPI | 1639580707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 905-L) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 87218) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2025034484) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2025-08-21 |