| NPI | 1437606381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-022857) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31842) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2017-03-02 |