| NPI | 1801821715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME92792) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME92729) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2018-12-11 |