| NPI | 1043854441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013763A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070024810) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2024-05-03 |