| NPI | 1073242913 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-027162) | 
| Additional Taxonomies | 225100000X Physical Therapist | 
| Enumeration Date | 2022-06-07 | 
| Last Update Date | 2022-12-28 |