| NPI | 1568524692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070015832) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 1911) |
| 2251C2600X Physical Therapist, Cardiopulmonary (Licence: NV 1911) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2022-08-23 |