| NPI | 1992076616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070018906) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010704A) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |