| NPI | 1750647426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA OS018178) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS018178) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS018178) | |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2018-02-01 |