| NPI | 1316114119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A121056) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036-130915) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 260245-1) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2023-11-27 |