| NPI | 1235257213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070006767) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IL 070006767) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2014-07-08 |