| NPI | 1760844179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MN 75093) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036159080) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-09-01 |