NPI | 1922774819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-028922) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1335739) |
Enumeration Date | 2021-08-19 |
Last Update Date | 2025-03-04 |