| NPI | 1447646005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 70890) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 1447646005) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2019-07-22 |