| NPI | 1609016344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 34.011169) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012365) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS016155) | |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2020-12-16 |