| NPI | 1730164815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 9745) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT24601) |
| 225100000X Physical Therapist (Licence: KY 006776) | |
| 225100000X Physical Therapist (Licence: IN 05012019A) | |
| 225100000X Physical Therapist (Licence: SC 7945) | |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2016-03-07 |