| NPI | 1427215920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2015-02029) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 48832) |
| 208100000X Physical Medicine & Rehabilitation (Licence: HI MD-17417) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2016-03-16 |