| NPI | 1104810399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME85999) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 038929) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME85999) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 038929) | |
| 208D00000X General Practice (Licence: FL ME85999) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2024-03-15 |