| NPI | 1417480708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A17383) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036164287) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 102325) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-06-03 |