| NPI | 1275526428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.081154) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.081154) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35081154) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2020-12-11 |