| NPI | 1790049229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.127953) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125061249) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.127953) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-10-18 |