| NPI | 1184917445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09710500) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA09710500) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 278489) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 278489) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2024-08-26 |