| NPI | 1073834321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NY 262494-01) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NJ 25MA09263500) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2020-12-21 |