| NPI | 1013577865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-025935) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ TBD) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2021-07-06 |