| NPI | 1609167980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN CV2201215) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 58656) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MN 58656) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-10-17 |