| NPI | 1730837386 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA PTL26839) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 070026478) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2023-05-25 |