| NPI | 1841462751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011593A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070002119) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2014-11-26 |