| NPI | 1811099021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1200X Physical Therapist, Ergonomics (Licence: IL 070009699) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IL 070009699) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070009699) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |