| NPI | 1285640318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 27835) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 27835) |
| 207T00000X Neurological Surgery (Licence: OH 35-061467) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 27835) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35-061467) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-09-13 |