| NPI | 1346471786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 252239) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA08540700) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 42159) | |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2014-02-27 |