| NPI | 1659601672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070017613) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05013718A) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2023-05-04 |