| NPI | 1730343237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 308392) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD441879) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036130817) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2023-01-02 |