| NPI | 1609937416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13531) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 70014874) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2021-06-23 |