| NPI | 1316768559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070027283) |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-11-13 |