| NPI | 1093129405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 63546) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 11018141A) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2018-04-11 |