| NPI | 1306136429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.127462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35 127462) |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2020-04-15 |