| NPI | 1891459178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 05014188A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05014188A) |
| Enumeration Date | 2021-10-23 |
| Last Update Date | 2021-10-23 |