| NPI | 1811181910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012369) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070015934) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2016-03-29 |