| NPI | 1093971574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 48740) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 48740) |
| 207L00000X Anesthesiology (Licence: IL 125055091) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2022-05-26 |