| NPI | 1740778919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 5195) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 009529) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-06-12 |