| NPI | 1558523084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036148298) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 40688) |
| 208D00000X General Practice (Licence: CA C155514) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2020-12-22 |