| NPI | 1033996046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05015193A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP-CP024446T) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-03-25 |