| NPI | 1558614024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013391A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070017366) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2022-12-08 |