NPI | 1497780886 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: IL 036075275) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036075275) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2021-01-27 |