| NPI | 1265439947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA 26118) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 26118) |
| 207L00000X Anesthesiology (Licence: IL 036079595) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036079595) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-01-22 |