| NPI | 1477795813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME117409) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME117409) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD205441) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2017-10-04 |