| NPI | 1013917426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35-060102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35060102) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH BL5196628) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-06-24 |