| NPI | 1336147107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OH 35-051439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35051439) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-12-02 |