| NPI | 1316970114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29006) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070006780) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2019-09-23 |