| NPI | 1780953182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05015756A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN TN-PT0000009151) |
| 225100000X Physical Therapist (Licence: OH PT017255) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2024-09-09 |