| NPI | 1174296396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070025967) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070.025967) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2021-07-28 |