| NPI | 1174843064 |
|---|---|
| Former Name | IRA BRUCE TETALMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101052269) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: VA 0101052269) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101052269) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-12-01 |