| NPI | 1285825273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16160-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021174) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2025-06-04 |