| NPI | 1285162099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301513260) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 66180) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2025-02-07 |