| NPI | 1508922527 |
|---|---|
| Former Name | IKYO PAK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 247616-B18) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT184507) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-12-06 |