| NPI | 1073573465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01066599A) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 44281) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101235883) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2010-11-05 |