| NPI | 1376091215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014851A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT0000010836) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2022-11-03 |