| NPI | 1134420995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011131A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070018198) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2018-05-31 |