NPI | 1366642688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05002712A) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IN 05002712A) |
2251X0800X Physical Therapist, Orthopedic (Licence: IN 05002712A) | |
Enumeration Date | 2007-07-24 |
Last Update Date | 2019-10-07 |