| NPI | 1962889444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070021303) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 1908) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |