| NPI | 1841565900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01074908A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 57.019541) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2023-11-27 |