| NPI | 1144269655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MB69953) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ MB69953) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |