| NPI | 1659680296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070010547) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2002008178) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2019-12-23 |