| NPI | 1154461739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IN 01068721A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-121122) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036-121122) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-05-08 |