| NPI | 1871176495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2026-03395) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.175467) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2026-03395) | |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2026-06-10 |