| NPI | 1366754293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA08978200) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA0898200) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NJ 25MA0898200) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2023-01-05 |