| NPI | 1245769892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014979) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070023050) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2021-01-25 |