| NPI | 1255586251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-018696) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029220) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2023-10-10 |