| NPI | 1679993000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IN 01088937A) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2018-02152) |
| 208100000X Physical Medicine & Rehabilitation (Licence: WY 11513A) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IN 99113777A) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2023-03-26 |