| NPI | 1124041926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35068757K) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-068757) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35-068757) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-01-14 |