| NPI | 1467819458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021982) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29325) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |