| NPI | 1164740122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 72134) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01074949A) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.137251) | |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2021-11-30 |