| NPI | 1013907500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05008949A) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: IN 05008949A) |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: MI 5501012113) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501012113) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-12-24 |