| NPI | 1184067670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010983A) |
| Additional Taxonomies | 2251C2600X Physical Therapist, Cardiopulmonary (Licence: IN 05010983A) |
| 2251S0007X Physical Therapist, Sports (Licence: IN 05010983A) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05010983A) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2013-07-16 |