| NPI | 1497936728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009597A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT19309) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2024-03-04 |