| NPI | 1992173868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05013532A) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305209786) |
| 225100000X Physical Therapist (Licence: IL 070022156) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2023-02-06 |