| NPI | 1447451380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT38241) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014146) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-02-10 |