| NPI | 1689889354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036121630) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35.129913) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A90587) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A90587) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.129913) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-12-20 |