| NPI | 1376184143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63780) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.024769) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2023-06-08 |