| NPI | 1326277898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070017102) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05009918A) |
| 225100000X Physical Therapist (Licence: IA 04425) | |
| 225100000X Physical Therapist (Licence: NM 3688) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |