| NPI | 1336470640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09836600) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA09836600) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 53918) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY DR0053918) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2024-10-02 |