| NPI | 1013961929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301060697) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01040664A) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2007-10-22 |