| NPI | 1598762841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: WI 51723-21) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: IL 036112357) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MI 5101017187) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2021-05-21 |