NPI | 1043289168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070012664) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 096-001522) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2017-02-24 |