| NPI | 1346534724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036138270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036138270) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036138270) | |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2024-10-02 |