| NPI | 1003971300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070015935) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT870705) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2008-11-26 |