| NPI | 1679724728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD015758E) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD015758-E) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA MD015758E) | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |