| NPI | 1891955498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0076008) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 095085) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA 440136) | |
| 207L00000X Anesthesiology (Licence: MA 232286) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2025-05-13 |