| NPI | 1336133289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01068862A) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.087875) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.087875) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2022-01-20 |