| NPI | 1477059640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0098279) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125073442) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2026-10-19 |