| NPI | 1326017625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036069946) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01038364A) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2021-02-12 |