| NPI | 1467223172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN CP032716T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP026513T) |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-08-15 |