| NPI | 1871654640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI MD-3267) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: HI MD-3267) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2016-07-23 |