| NPI | 1710958640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 51484) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036098067) |
| 207L00000X Anesthesiology (Licence: IL 036098016) | |
| 207Q00000X Family Medicine (Licence: IL 036098016) | |
| 207Q00000X Family Medicine (Licence: IL 036098067) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036098016) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-03-14 |