| NPI | 1821489881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021855) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014026966) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2025-04-09 |