| NPI | 1457648073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036-140895) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036140895) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2022-04-26 |