| NPI | 1245246321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070013280) |
| Additional Taxonomies | 251E00000X Home Health (Licence: IL 1011932) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-07-17 |