| NPI | 1942685789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070023479) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT4532) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2021-03-26 |