| NPI | 1477910487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-022051) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 082038) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2022-04-20 |