| NPI | 1396980181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36571) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016785) |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2010-07-20 |