| NPI | 1518646447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070029724) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 6259) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2026-04-22 |