NPI | 1538450770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036-101920) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-101920) |
Enumeration Date | 2011-04-21 |
Last Update Date | 2022-04-22 |