| NPI | 1124433230 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036146426) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125065178) | 
| Enumeration Date | 2014-06-26 | 
| Last Update Date | 2022-06-01 |