| NPI | 1134669583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1281437) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 070022693) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |