| NPI | 1427775105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1406739) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05015863A) |
| 208100000X Physical Medicine & Rehabilitation (Licence: KS 1406739) | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2025-12-25 |