| NPI | 1336319094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036124700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.009044) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036124700) | |
| Enumeration Date | 2008-03-08 |
| Last Update Date | 2012-09-11 |