| NPI | 1194381400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014843A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT34457) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-04-22 |