| NPI | 1699827931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: NC 11176) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05006843A) |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: IN 05006843A) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-08-15 |