| NPI | 1225307853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036101415) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD014307E) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2011-12-28 |