| NPI | 1093142093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: HI MD10925) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA G67918) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |