| NPI | 1861856650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022880) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011957A) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2017-04-05 |