| NPI | 1457067365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028953) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160008196) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2025-03-03 |