| NPI | 1891987988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 70015971) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7321) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-09-10 |