NPI | 1154675700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070003795) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070003795) |
Enumeration Date | 2012-11-05 |
Last Update Date | 2022-09-01 |