| NPI | 1952510364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 07000498) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital (Licence: IL 070.04098) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-10-02 |