| NPI | 1235183005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD421876) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY A195609-1) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY A195609-1) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA08916500) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: PA MD421876) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NY A195609-1) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NJ 25MA08916500) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-02-17 |