NPI | 1649308735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.019705) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070019705) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2024-07-12 |