| NPI | 1922449115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WV 27116) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 27116) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WV 27116) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2023-06-18 |