| NPI | 1649362732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12270-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014460) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2025-10-07 |