| NPI | 1699121418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022899) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31361) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2017-04-13 |