| NPI | 1497727382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 80382) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME80382) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME80382) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-04-03 |