| NPI | 1760011845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME158773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME158773) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME158773) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2024-05-17 |