| NPI | 1467646083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO ptl0014204) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070015917) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2016-10-26 |