| NPI | 1932115631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036-094656) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-094656) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-094656) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME 97427) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-05-18 |