NPI | 1205210150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01081583A) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 52324) |
208100000X Physical Medicine & Rehabilitation (Licence: NY 295616) | |
Enumeration Date | 2015-07-09 |
Last Update Date | 2019-09-06 |