| NPI | 1558694539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX R2266) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.095398) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35.095398) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2022-06-17 |