| NPI | 1558477349 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036-085900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-085900) |
| 207R00000X Internal Medicine (Licence: IL 036-085900) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-09-26 |