| 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 |