| NPI | 1932594702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 58496) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN 58496) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-06-24 |