| NPI | 1285587196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872234) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA CP048505T) |
| 225100000X Physical Therapist (Licence: IN CP052612T) | |
| Enumeration Date | 2026-02-19 |
| Last Update Date | 2026-02-19 |