| NPI | 1801489828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 5234) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.025309) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2023-10-11 |