| NPI | 1255450623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070012723) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9870) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-04-19 |