| NPI | 1922592880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD479688) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01088086A) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2025-11-26 |