| NPI | 1043274350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO MD108645) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MO MD108645) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NJ 25MA09914200) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09914200) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-01-31 |