| NPI | 1487911798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ LPT-009840) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.016266) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2025-03-06 |