| NPI | 1184115214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.074542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11212) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2019-08-12 |