| NPI | 1356872576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IL 036-156029) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036156029) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-02-09 |