| NPI | 1619094034 |
|---|---|
| Former Name | SUJOY BASU |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501007326) |
| Additional Taxonomies | 2251C2600X Physical Therapist, Cardiopulmonary (Licence: MI 5501007326) |
| 2251N0400X Physical Therapist, Neurology (Licence: MI 5501007326) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501007326) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2008-02-28 |