| NPI | 1780709493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036-115696) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX MDN4491) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2013-06-17 |