| NPI | 1639795669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125078145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020017706) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2021-06-25 |