| NPI | 1801966999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036076500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036076500) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036076500) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-08-28 |