| NPI | 1457193559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 99125288A) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IN 99125288A) |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |