| NPI | 1245462670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME118721) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME118721) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME118721) | |
| 207L00000X Anesthesiology (Licence: IL 036-129708) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036-129708) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2026-01-07 |