NPI | 1548795644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME157775) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME157775) |
208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME157775) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL 32446) | |
Enumeration Date | 2017-04-26 |
Last Update Date | 2025-02-11 |