| NPI | 1134547185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35132923CTR) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35132923) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-03-08 |