| NPI | 1013964998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070017505) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008712A) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2014-08-13 |