| NPI | 1780362483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: IL 00124964401) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 00124964401) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-11 |