| NPI | 1033493622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05011654A) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT010453) |
| Enumeration Date | 2011-10-01 |
| Last Update Date | 2020-06-25 |