| NPI | 1225665730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: MN 76233) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125077736) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-07-27 |