| NPI | 1750577524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-016056) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7930) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2024-04-29 |