| NPI | 1730100413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35041372) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-041372) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-03-26 |