| NPI | 1861754848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR.0056986) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 12506113) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2019-08-02 |