| NPI | 1700071321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 01779) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070013292) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2023-03-22 |