| NPI | 1659502615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013123A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35880) |
| 225100000X Physical Therapist (Licence: IL 070021776) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2018-08-21 |