| NPI | 1053379578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036104737) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036104737) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-12-08 |