NPI | 1477442804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: IL 070.029136) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2025-07-01 |
Last Update Date | 2025-08-17 |