| NPI | 1386078731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022159) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022891) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2016-06-06 |