| NPI | 1518311422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036.157680) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036157680) |
| 207L00000X Anesthesiology (Licence: IL 036157680) | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2023-11-25 |