| NPI | 1881075679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 5351) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT0000010465) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2023-09-26 |