| NPI | 1326548314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN LPT-013642) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 13946) |
| 225100000X Physical Therapist (Licence: AZ 13642) | |
| 225100000X Physical Therapist (Licence: GA PT015133) | |
| 225100000X Physical Therapist (Licence: AL PTH10174) | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2024-09-10 |