| NPI | 1184739476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME87545) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME87545) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME87545) | |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: FL ME87545) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME87545) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-07-10 |