| NPI | 1568101855 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026845) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070026833) | 
| Enumeration Date | 2022-06-03 | 
| Last Update Date | 2022-08-22 |