| NPI | 1699540690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014662A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD CP025058T) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |