| NPI | 1629606686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036175969) |
| Additional Taxonomies | 208VP0000X (Licence: IL 036175969) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036175969) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-07-27 |