NPI | 1235285636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-009751) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL 5870) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2007-07-08 |