| NPI | 1609174259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070018842) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID ID-2804) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2012-07-31 |