| NPI | 1295706190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-016388) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 007705) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2008-07-01 |