| NPI | 1336462423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME107803) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME107803) |
| 207R00000X Internal Medicine (Licence: FL ME107803) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2018-06-05 |