| NPI | 1275723348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 5MA08611000) |
| Additional Taxonomies | 208VP0000X (Licence: NJ 25MA08611000) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2025-10-01 |