| NPI | 1184877151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: GA 72337) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 72337) |
| 208100000X Physical Medicine & Rehabilitation (Licence: UT 7151986-1205) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 01069420A) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: UT 7151986-8905) | |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2026-05-13 |