| NPI | 1295430031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028269) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16301-24) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-09-10 |