| NPI | 1922539568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: MN 71779) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 10955781-1205) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: IL 036155304) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2022-09-22 |