| NPI | 1285015024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35704) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021601) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2020-06-08 |