| NPI | 1306887484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05004619A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-013919) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-01-23 |