Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1003118977 |
---|---|
Provider Name | Karan Bobby Johar |
First Address | Charlotte, NC 28207-2042 |
Second Address | Charlotte, NC 28215-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2010 |
Last Update Date | 29/11/2010 |