| NPI | 1417128901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-016253) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002601) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2015-01-14 |