NPI | 1912901752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 091290A) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 27076) |
Enumeration Date | 2005-06-09 |
Last Update Date | 2018-10-01 |