| NPI | 1508945494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME90237) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME90237) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME90237) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME90237) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2017-04-17 |