| NPI | 1720521156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.022742) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070022742) |
| Enumeration Date | 2016-12-03 |
| Last Update Date | 2021-09-28 |