| NPI | 1952587503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 27605) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD433272) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-8249) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: OK 27605) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2017-07-06 |