| NPI | 1235394891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME133521) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME133521) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO DR.0066118) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2023-03-01 |