| NPI | 1912942400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.076781) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.076781) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-06-01 |