| NPI | 1275588774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34-004870) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OH 34-004870) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-07-03 |