| NPI | 1306406749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MB12257600) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA OS021086) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-07-11 |