NPI | 1689103806 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD214071) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.156632) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214024) | |
Enumeration Date | 2017-06-09 |
Last Update Date | 2023-03-23 |