| NPI | 1568671782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2010-0414) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: OH 35.089725) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NC 2010-00414) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2010-00414) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 2010-00414) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-07-27 |