| NPI | 1598024259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05005231A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 07009728) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |