| NPI | 1306200340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 65640) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.152938) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-03-21 |