| NPI | 1548257397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.027599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 005898) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2023-11-15 |