| NPI | 1841335742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI WI10300-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL IL70013849) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2025-07-11 |