NPI | 1679558092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05007614A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005057) |
Enumeration Date | 2005-12-08 |
Last Update Date | 2019-01-30 |