| NPI | 1467772376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036.138147) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.138147) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2020-02-11 |