| NPI | 1548829153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ME DO3940) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.076221) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2024-09-30 |