| NPI | 1467468033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-014348) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03745) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2010-10-14 |