| NPI | 1427160944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35-085005) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: KY 39035) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-30 |