| NPI | 1518216258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070020794) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24098) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2014-10-15 |