| NPI | 1386489805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014303A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 304502) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-07-02 |