| NPI | 1376983577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05012441A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10258) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2023-09-29 |