| NPI | 1609812569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036-117176) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 52090-020) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IN 01062459A) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2011-11-09 |