| NPI | 1083015986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070013746) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008060A) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |