| NPI | 1952982720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.079393) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.079393) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2023-07-02 |