| NPI | 1366446122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: IN 01045512A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01045512A) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-09-12 |