| NPI | 1174201099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070.026600) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 304632) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-05-01 |