| NPI | 1457842296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT7064) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070023513) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2021-09-01 |