| NPI | 1881929362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070017401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 0501890A) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2013-12-03 |