| NPI | 1619372182 |
|---|---|
| Former Name | SUDHARSHAN GAUTAM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MA 11319) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |