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 | 2024-08-16 |