| NPI | 1548218167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070011555) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10070024) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-12-05 |