| NPI | 1033731526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036169095) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS19315) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT020071) | |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2025-01-31 |