| NPI | 1952006926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.027313) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22028) |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2023-03-31 |