| NPI | 1265461958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-010887) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 6036024) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-03-17 |