| NPI | 1508985995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011237A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070006389) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2019-01-02 |