| NPI | 1639482920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036135448) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 11066862-1204) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2021-01-20 |