| NPI | 1285887935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.016182) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008382) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |