| NPI | 1598950990 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME159083)  | 
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME159083)  | 
| 208100000X Physical Medicine & Rehabilitation (Licence: FL ME159083)  | |
| 208VP0000X  (Licence: FL ME159083)  | |
| Enumeration Date | 2007-09-09 | 
| Last Update Date | 2024-02-27 |