| NPI | 1194955658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: OH 34011483) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34011483) |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2022-01-25 |