| NPI | 1285688747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA07355800) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD065466L) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 307356) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL ME152938) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-06-10 |