| NPI | 1306459227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.013718) |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2024-03-25 |