| NPI | 1750720025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME128750) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME128750) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2022-08-17 |