NPI | 1659509578 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070017530) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 019564) |
225100000X Physical Therapist (Licence: TX 1311723) | |
Enumeration Date | 2009-06-30 |
Last Update Date | 2023-06-17 |