| NPI | 1871516021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL me069227) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME69227) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL me069227) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-04-05 |