| NPI | 1649291410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA06687700) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA06687700) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA06687700) | |
| 208VP0000X (Licence: NJ 25MA06687700) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-12-18 |