| NPI | 1013942358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME144162) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M6482) |
| 207R00000X Internal Medicine (Licence: MA 227336) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME144162) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-02-14 |