| NPI | 1255429379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 291488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070011036) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2016-09-01 |