| NPI | 1730145285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 45893) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: TN 45893) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: TN 45893) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2018-05-25 |