| 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 |