| NPI | 1063239622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.029712) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 306872) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2026-03-05 |