| NPI | 1821652983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013458A) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-12-03 |