| NPI | 1780249623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070039783) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IL 070039783) |
| 225100000X Physical Therapist (Licence: AZ LPT-30794) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2026-06-09 |