| NPI | 1881607588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 254227) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301076957) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MI 4301076957) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MA 254227) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-11-22 |