| NPI | 1346862430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026502) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 096003445) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-10-16 |