| NPI | 1255307633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NJ 25MA05481800) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-07-08 |