| NPI | 1508808171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME51845) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME51845) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2011-06-16 |