| NPI | 1962449801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD456006) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01081571A) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-11-16 |