| NPI | 1649341983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.096379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD427683) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 51050) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD437683) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2019-01-14 |