| NPI | 1629398748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q1734) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036131742) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2021-11-04 |