| NPI | 1679744833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301117210) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX BP10023392) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036120935) | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2021-03-31 |