| NPI | 1427473693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-020562) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 072796) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-04-18 |