| NPI | 1861572653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME44332) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME44332) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME44332) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-06-09 |