| NPI | 1770088189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036.158666) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036.158666) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.158666) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2025-05-22 |