| NPI | 1396910394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026592) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160-002656) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2022-08-25 |