| NPI | 1487870598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009178A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028554-1) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-08-02 |