| NPI | 1023632650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS21099) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125076425) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2024-09-03 |