| NPI | 1568605806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.161384) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 271682) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 21123) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036.161384) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2023-02-03 |