NPI | 1255323606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME122061) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036099120) |
Enumeration Date | 2005-08-20 |
Last Update Date | 2020-01-27 |