| NPI | 1003881319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.150092) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: ME MD14080) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2024-04-05 |