| NPI | 1205161163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011697A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH5625) |
| 225100000X Physical Therapist (Licence: GA PT009785) | |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2017-04-25 |