| NPI | 1154795821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.081290) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.081290) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2024-06-12 |