| NPI | 1225367584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05008434A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205244) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |