| NPI | 1013668482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014267A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070026210) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |