| NPI | 1477705192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070015829) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2007004519) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2020-05-21 |