| NPI | 1013535061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021773) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: 070.021773) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-11-24 |