| NPI | 1003915976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301058252) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01046894A) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-03-02 |