| NPI | 1447709563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05012281A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-4743) |
| 225100000X Physical Therapist (Licence: MO 2016032977) | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2017-04-26 |