| NPI | 1306002761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A127144) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125054209) |
| 207L00000X Anesthesiology (Licence: CA A127144) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2018-10-01 |