| NPI | 1275586687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 159200) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: NY 159200) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: NY 1592000) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 1592000) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2014-09-04 |