| NPI | 1629180922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05008972A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 99021235A) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-07-26 |