| NPI | 1730793605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 009174) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05013942A) |
| 225100000X Physical Therapist (Licence: IN CV2003640) | |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2024-09-18 |