| NPI | 1639725443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.024571) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070024571) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |