| NPI | 1891887048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35054847) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35054847) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-03-27 |