| NPI | 1437617370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 4139) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 5596) |
| 225100000X Physical Therapist (Licence: MO 2016042475) | |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |