| NPI | 1609094366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05007545A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 70013348) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2019-12-11 |