| NPI | 1861817785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 6367) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NE 1346) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2025-07-08 |