| NPI | 1508212374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022241) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IL 070022241) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2021-03-11 |