| NPI | 1740287424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35068099S) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35068099) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-02-04 |