| NPI | 1144460270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-0111436) |
| Additional Taxonomies | 2251C2600X Physical Therapist Cardiopulmonary (Licence: IL 070-0111436) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |