| NPI | 1154577708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26570) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016628) |
| 225X00000X Occupational Therapist (Licence: IL 056-008419) | |
| 225X00000X Occupational Therapist (Licence: FL PT26570) | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2015-04-13 |