| NPI | 1588632806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT010325) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070011972) |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2024-11-06 |