| NPI | 1942217229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME90421) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-102338) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: IL 036-102338) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IL 036-102338) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: PA MD-433045) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MD-433045) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-07-02 |