| NPI | 1467177543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT017461) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-026912) |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2024-11-21 |