| NPI | 1528990827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT018476) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070039849) |
| Enumeration Date | 2026-06-01 |
| Last Update Date | 2026-08-14 |