| NPI | 1851234785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070.026449) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IA 004178) |
| Enumeration Date | 2026-04-14 |
| Last Update Date | 2026-04-14 |