| NPI | 1447078670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12752) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05015771A) |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2025-02-19 |