| NPI | 1801515671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070027148) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT302598) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2024-06-03 |