NPI | 1679589717 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036-087401) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036-087401) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-087401) | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2014-02-07 |