| NPI | 1588867378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 7851) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05007694A) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2008-08-19 |