NPI | 1053873950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 34.015940) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 34.015940) |
208D00000X General Practice (Licence: OH 34.015940) | |
Enumeration Date | 2019-04-01 |
Last Update Date | 2024-08-25 |