| NPI | 1063611895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2008003901) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 336-076787) |
| 208VP0000X (Licence: IL 036115525) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2020-11-10 |