| NPI | 1376075135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.139030) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.139030) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036.155647) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2024-07-23 |