| NPI | 1316244908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24566) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 0700018282) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2015-07-10 |