| NPI | 1093049579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME104746) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL ME104746) |
| 207T00000X Neurological Surgery (Licence: FL ME104746) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |