| NPI | 1699107219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070020747) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10436) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2014-11-21 |