| NPI | 1245262922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB07829000) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: NJ 25MB07829000) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-04-03 |