NPI | 1396373502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-171652) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA 61158152) |
Enumeration Date | 2020-04-01 |
Last Update Date | 2024-11-05 |