| NPI | 1962678052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070015607) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227001920) |
| 2251S0007X Physical Therapist, Sports (Licence: IL 070015607) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: IL 070015607) | |
| 2251E1200X Physical Therapist, Ergonomics (Licence: IL 070015607) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2012-08-02 |