| NPI | 1326423930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 68215) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 567279) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 02005652A) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2021-09-22 |