| NPI | 1699736173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101038970) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: LA 13324R) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 13324R) | |
| 174400000X Specialist (Licence: LA 13324R) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 13324R) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: LA 13324R) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-04-15 |