| NPI | 1841846383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028907) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 096848) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2025-05-06 |