| NPI | 1679583082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX N1498) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 36-100971) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-01-14 |