| NPI | 1447391305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12238-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014604) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2018-12-07 |