| NPI | 1306196571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-019428) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 07019428) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2021-07-30 |