| NPI | 1538433107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022896) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 30311) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2022-07-21 |