| NPI | 1114410750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05012994A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 99086715A) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-01-19 |