| NPI | 1477905958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31169) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 05012418A) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2025-03-05 |