NPI | 1710023668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PR 7092) |
Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: PR 7092) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2007-07-08 |