| NPI | 1144711482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070027107) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12894) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2022-12-05 |