| NPI | 1861687923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 02003462A) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125050599) | 
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 02003462A) | |
| Enumeration Date | 2007-09-12 | 
| Last Update Date | 2019-02-04 |