| NPI | 1356409411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C54416) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036094493) |
| 207L00000X Anesthesiology (Licence: IL 036094493) | |
| 207R00000X Internal Medicine (Licence: IL 036094493) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2016-05-23 |