| NPI | 1306810908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070020572) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 023171) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2014-03-27 |