| NPI | 1609388974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-4200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011725A) |
| 225100000X Physical Therapist (Licence: IL 070022951) | |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |