| NPI | 1164627485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-016163) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008916A) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2010-11-11 |