| NPI | 1720336894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010977A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 99053331A) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2023-05-04 |