| NPI | 1326401308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010302A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070015154) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-09-16 |