| NPI | 1629067608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: IL 036092697) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036092697) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036092697) | |
| 207Q00000X Family Medicine (Licence: IL 036092697) | |
| 208VP0000X (Licence: GA 068362) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036092697) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 068362) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2019-12-31 |