| NPI | 1144516691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05004375A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070008887) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |