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 |