| NPI | 1578541751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.005384) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070-005384) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2015-10-08 |