| NPI | 1437525722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05012965A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1265739) |
| 225100000X Physical Therapist (Licence: SC 7849) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-12-03 |