| NPI | 1558886564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070024039) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22997) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2018-10-12 |