| NPI | 1023472453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022985) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017226) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-10-14 |