| NPI | 1982772471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME56039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.065621) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2018-02-20 |