| NPI | 1285302596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: IN 05010652A) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010652A) | 
| Enumeration Date | 2021-09-01 | 
| Last Update Date | 2022-12-27 |