NPI | 1154491611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35080788) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.080788) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2023-06-13 |