| NPI | 1013575182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 73428) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 73428) |
| 207L00000X Anesthesiology (Licence: IL 125.074121) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2023-10-17 |