| NPI | 1841581899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA10186300) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 264730) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2019-11-25 |