| NPI | 1194603555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT309017) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.028578) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2026-01-01 |