| NPI | 1053501916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA08717800) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08717800) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 254259) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 254259) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2019-12-06 |