| NPI | 1932140498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME91065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME91065) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-05-02 |