| NPI | 1003546953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026599) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: AZ LPT-034714) | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2026-09-25 |