NPI | 1619398393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-6738) |
Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic |
Enumeration Date | 2013-12-23 |
Last Update Date | 2023-02-22 |