| NPI | 1326205808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036132945) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD476082) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2022-03-23 |