| NPI | 1437310448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NJ 25MA08277400) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: NJ 25MA08277400) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-05-12 |