| NPI | 1265873756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070018228) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011009210) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |