| NPI | 1023245925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IL 036130049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01074150) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2024-02-09 |