| NPI | 1043554439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME152659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME152659) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 111N00000X Chiropractor (Licence: FL CH10790) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2023-08-09 |