| NPI | 1104082320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036125625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125048096) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036125625) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2022-05-18 |