| NPI | 1235116625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AR N-6767) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2008022986) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2019-11-18 |