| NPI | 1508312448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-21054) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070022378) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2022-07-12 |