| NPI | 1851684245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 66095) |
| Additional Taxonomies | 208VP0000X (Licence: GA 66095) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 66095) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2025-10-30 |