| NPI | 1194334003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013113A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.023033) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-08-18 |