| NPI | 1720385719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070018334) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010787A) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2024-08-13 |