| NPI | 1801880232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA05332800) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA05332800) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2025-01-03 |