| NPI | 1336327279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA08436100) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX M2869) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 059349) | |
| Enumeration Date | 2008-02-02 |
| Last Update Date | 2024-04-25 |