| NPI | 1497782940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA7245700) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA07245700) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-02-21 |