| NPI | 1427064575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-012133) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-010262) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-11-18 |