| NPI | 1255610937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: IL 036.099392) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036099392) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2024-04-09 |