| NPI | 1407080153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12772-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010782A) |
| 225100000X Physical Therapist (Licence: IL 070017165) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2024-09-19 |