| NPI | 1851703474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 59669) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TN 59669) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2023-09-22 |