| NPI | 1710325667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036-161710) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 270386) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-08-22 |