| NPI | 1730304577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014499A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014283) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2024-08-12 |