| NPI | 1326359852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.017570) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008593) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-02-13 |