| NPI | 1144494386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501004129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070002822) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2015-03-18 |