| NPI | 1871276808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070039967) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2026-07-30 |