| NPI | 1275500431 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070004239) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01412) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-10-03 |