| NPI | 1568472520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NE 24699) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 120887) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 24699) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2023-09-13 |