| NPI | 1649269002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IA 20765) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036086184) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2015-01-19 |