| NPI | 1912509977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070028333) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 298463) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2025-04-08 |