| NPI | 1649989294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16527) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05014886A) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2026-05-11 |