| NPI | 1922237361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05011284A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009666) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2023-01-19 |