| NPI | 1043644180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 10445) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070022676) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2022-07-21 |