| NPI | 1720137250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-007832) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39749) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-10-07 |