| NPI | 1578855847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101021514) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL Pending) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2020-12-22 |