| NPI | 1407323033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014535A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018039706) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2024-10-15 |