| NPI | 1790528883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028725) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05015837A) |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-12-17 |