| NPI | 1912967142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME93997) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL me93997) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME93997) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME93997) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2016-07-28 |