| NPI | 1457733008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX V4239) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101024545) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.151616) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2025-08-04 |