| NPI | 1932548344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AR E11173) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: AR E11173) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD461254) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT204432) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-12-01 |