| NPI | 1609302637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022945) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05012167A) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-06-14 |