| NPI | 1386335917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05015093A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 8692) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-23 |