NPI | 1376809566 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.143289) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.143289) |
208VP0000X Pain Medicine, Pain Medicine (Licence: IN 01078377A) | |
Enumeration Date | 2012-04-02 |
Last Update Date | 2021-09-27 |