| NPI | 1992758783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: WI 46167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036115483) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036115483) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-11-29 |