| NPI | 1861667370 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35-090324) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-090324) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35-090324) | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2017-03-31 |