| 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 |