| NPI | 1891896205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010558A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070013101) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-08-12 |