| NPI | 1326364944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 139848) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 139848) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2021-08-30 |