| NPI | 1093971004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: IL 036-120386) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-120386) |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: OH 35.095818) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.095818) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2019-10-17 |