| NPI | 1730537572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS18132) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ THDO00018) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS18132) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2024-11-15 |