| NPI | 1598013450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 9360) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP033369T) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2024-09-04 |