| NPI | 1245418490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NM A-1668-12) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101017418) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 125053960) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2017-03-22 |