| NPI | 1790221158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.012014) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2022-04-20 |