| NPI | 1548615750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX T7112) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-153211) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX T7112) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2023-08-15 |