| NPI | 1316364300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06597) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-020594) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2023-08-29 |