| NPI | 1649337700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA L#08395R) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA L#08395R) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2008-12-04 |