| NPI | 1598786949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10284-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-010714) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-12-07 |