| NPI | 1073378261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014657A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 05014657A) |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-20 |