| NPI | 1750441374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2011029728) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036-097826) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-03-01 |