| NPI | 1124487665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704318361) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4704318361) |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: MI 4704318361) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MI 4704318361) | |
| 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: MI 4704318361) | |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MI 4704318361) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4704318361) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4704318361) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2024-04-02 |