| NPI | 1770512972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 31430) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036115940) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 31430) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2021-09-23 |