| NPI | 1417915596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01094928A) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 00023044) | 
| 208100000X Physical Medicine & Rehabilitation (Licence: LA 311032) | |
| Enumeration Date | 2006-05-01 | 
| Last Update Date | 2025-05-19 |