| NPI | 1881781151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14959-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070013211) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-26 |