NPI | 1063698645 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N2492) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57-011358) |
Enumeration Date | 2008-01-14 |
Last Update Date | 2024-01-16 |