| NPI | 1184633703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05005672A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08001260A) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-11-16 |