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 |