| NPI | 1144041989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014677A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 42124) |
| 225100000X Physical Therapist (Licence: TX 1367099) | |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |