| NPI | 1073012092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026020) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 293696) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2025-09-15 |