| NPI | 1205946233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010344A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 10010456) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-02-07 |