| NPI | 1528144409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010304A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016269) |
| 225100000X Physical Therapist (Licence: SC 5388) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2011-02-16 |