| NPI | 1427497122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-142584) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301105954) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2017-12-04 |