| NPI | 1871728584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010723A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.017057) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2017-01-03 |