| NPI | 1366467797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DE c1-0005687) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA md054290L) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ ma06671200) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-09 |