| NPI | 1366094989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070025964) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT014101) |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2025-09-19 |