| NPI | 1134104037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 44383) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A055622) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036147433) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2024-10-02 |