| NPI | 1003047192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010651A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016986) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2017-04-27 |