| NPI | 1073538971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD427039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 290802) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D65463) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09061400) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-10-10 |