| NPI | 1689930059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070019624) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 2967) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-12-05 |