| NPI | 1851352629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME54328) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME54328) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: FL ME54328) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2014-08-12 |