| NPI | 1912218009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036-127377) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.054301) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2014-06-18 |