NPI | 1043635063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015014052) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070020566) |
Enumeration Date | 2014-02-27 |
Last Update Date | 2016-09-01 |