| NPI | 1104264506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036.147721) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125063352) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2021-04-06 |