NPI | 1053514653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ 25MB09887900) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL os10552) |
207Q00000X Family Medicine (Licence: NJ 25MB09887900) | |
207Q00000X Family Medicine (Licence: FL OS10552) | |
208D00000X General Practice (Licence: NY 238708) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS10552) | |
Enumeration Date | 2007-06-09 |
Last Update Date | 2016-07-12 |