| NPI | 1851658397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB10036700) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25mb10036700) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2022-09-21 |