| NPI | 1982860193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 104722) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 104722) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2019-12-05 |