| NPI | 1790785921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA07181100) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07181100) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA07181100) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-12-20 |