| NPI | 1831693530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: FL OS16340) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS16340) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-08-09 |