| NPI | 1831313352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MB08101500) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS013296) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB08101500) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MB08101500) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2024-05-24 |