| NPI | 1376277905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014727A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070026760) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-09-26 |