| NPI | 1407868318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070012480) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT2174) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-11-26 |