| NPI | 1528441078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IA MD-49030) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036154127) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IA MD-49030) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2021-12-09 |