| NPI | 1639356744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-07313) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 0700002325) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2024-02-27 |