| NPI | 1497538052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 034138) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05014884A) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2025-07-30 |