| NPI | 1770928228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011573A) |
| 225100000X Physical Therapist (Licence: IL 070016535) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2023-06-09 |