| NPI | 1427446988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.020960) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011634A) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2017-10-18 |