| NPI | 1588680359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MB083399400) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA OS013745) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-12-16 |