NPI | 1639309180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X (Licence: AZ 006195) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 006195) |
208100000X Physical Medicine & Rehabilitation (Licence: IL BF4649604A392) | |
Enumeration Date | 2009-07-18 |
Last Update Date | 2025-08-27 |