| NPI | 1376226092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2023032417) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-12-23 |