| 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 |