| NPI | 1467888974 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251C2600X (Licence: IL 070021127) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021127) | 
| Enumeration Date | 2013-09-17 | 
| Last Update Date | 2024-02-21 |