| NPI | 1992110548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125.066202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021072) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2015-06-22 |