NPI | 1710912498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OH 34.016792) |
Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: WV 2077) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2024-04-09 |