| 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 | 2025-03-26 |