| NPI | 1134530926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0000X (Licence: FL ME139293) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD38074) | 
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME139293) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 085105) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME139293) | |
| Enumeration Date | 2014-05-14 | 
| Last Update Date | 2024-08-15 |