| 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 |