| NPI | 1477364545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017539) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05013956A) |
| 225100000X Physical Therapist (Licence: NJ 40QA02232200) | |
| 225100000X Physical Therapist (Licence: IL 070025427) | |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-16 |