| NPI | 1154571867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0055868) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125052478) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MO 2011011361) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2022-07-20 |