| NPI | 1811425796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29754) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070023188) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-02-27 |