| NPI | 1255420881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070018872) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160003800) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-08-30 |