NPI | 1326420159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101024889) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.067956) |
Enumeration Date | 2015-06-29 |
Last Update Date | 2021-02-22 |