| NPI | 1285847699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.087753) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD462767) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-06-11 |