| NPI | 1043818495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN CV2201366) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501019790) |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2022-08-16 |