| NPI | 1336191170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35086736) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35086736) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.086736) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-11-02 |