| NPI | 1245913888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05015280A) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: IN 05015280A) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-10 |