| NPI | 1689644106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03195) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-013325) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2007-07-08 |