| NPI | 1710960570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA05547100) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NJ 25MA05547100) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NJ 25MA05547100) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2019-10-01 |