| NPI | 1841503612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-018739) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020771) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2011-10-10 |