| NPI | 1891100426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-020731) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 073981) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-07-18 |