| NPI | 1184654808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 74355) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 74355) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME74355) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-11-02 |