| NPI | 1457502619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125051773) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 02004506A) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2025-10-03 |