| NPI | 1083081731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022132) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 30630) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2016-11-15 |