| NPI | 1265870588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01081602A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-9785) |
| Enumeration Date | 2013-06-09 |
| Last Update Date | 2019-06-27 |