| NPI | 1871520718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS7098) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-131304) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036-131304) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-08-31 |