| NPI | 1194744995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13522) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-014551) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-07-24 |