| NPI | 1487499265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND CP043921T) |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2025-09-18 |