| NPI | 1013077395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 233661-1) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 233661-1) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 233661-1) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: NY 233661-1) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 233661-1) | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NY 233661-1) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NY 233661-1) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 233661-1) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 233661-1) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 233661-1) | |
| 209800000X Legal Medicine (Licence: NY 233661-1) | |
| 2085B0100X Radiology, Body Imaging (Licence: NJ 25MA07825600) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NJ 25MA07825600) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07825600) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NJ 25MA07825600) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2021-10-14 |