| NPI | 1295446383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32707) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.027038) |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2022-12-08 |