| NPI | 1689810855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036148596) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102202454) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101020702) | |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2022-10-26 |