| NPI | 1790099364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-027208) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8978) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2025-03-27 |