| NPI | 1932316320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-123746) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A103573) |
| 2081H0002X (Licence: OH 35.089617) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-07-06 |