| NPI | 1396411591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070024156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14481) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |