| NPI | 1003887043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35121261) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35121261) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A121143) | |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2025-03-13 |