| NPI | 1477877991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 75190) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME140297) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-137007) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: IL 036-137007) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2023-10-31 |