| NPI | 1881690659 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05006551A) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 05006551A) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2009-04-24 |