| NPI | 1922568930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.017028CTR) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34.017028) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 34.017028) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-11-03 |