| NPI | 1760422844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070004781) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05006094A) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2018-04-16 |