| NPI | 1669856837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021378) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 07021378) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2019-01-16 |