| NPI | 1871678060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 43720) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-100237) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |