| NPI | 1972551273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05007758A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070013223) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-08-22 |