| NPI | 1700073392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 26755) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY ky43013) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 01067039A) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01067039A) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY ky43013) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2022-04-08 |