| NPI | 1568185999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-026962) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL pending) |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2025-05-02 |