| NPI | 1063948529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 68595) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 274910) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 93296) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TN 63159) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 282952) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2023-09-20 |