| NPI | 1649566910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010713A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9070) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2012-02-08 |