| NPI | 1346188521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP051225T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP049385T) |
| 225100000X Physical Therapist (Licence: TN 13366) | |
| Enumeration Date | 2026-03-23 |
| Last Update Date | 2026-03-23 |