| NPI | 1992972590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009512A) |
| Additional Taxonomies | 171W00000X Contractor (Licence: IN 05009512A) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2024-06-25 |