| NPI | 1427297589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05007308A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205291) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2024-05-16 |