| NPI | 1346273562 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.147931)  | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.147931)  | 
| Enumeration Date | 2006-07-09 | 
| Last Update Date | 2024-08-21 |