| NPI | 1760702625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070023397) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61391) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-02-21 |