| NPI | 1427242510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006238) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-015915) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2013-08-12 |