| NPI | 1932738093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013708A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27865) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |