| NPI | 1154506376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME107723) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME107723) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2026-07-04 |