| NPI | 1265400287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA06804200) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD445487) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 291554-1) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA06804200) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2025-11-07 |