| NPI | 1982012084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011440A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29284) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |