| NPI | 1124028923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34005063) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 34.005063) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 34005063) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2022-07-28 |