| NPI | 1548496599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 302622) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-135692) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036.135692) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2022-10-12 |