| NPI | 1447396981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT20224) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021185) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2026-02-12 |