| NPI | 1669586707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-008721) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-12-18 |