| NPI | 1891162244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015617) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021804) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2025-02-04 |