| NPI | 1922208610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME109028) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: FL ME109028) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: FL ME109028) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME109028) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-02-27 |