| NPI | 1831352616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N0437) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX N0437) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX N0437) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-01-11 |