| NPI | 1225233307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010388A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60132052) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2016-10-27 |