| NPI | 1881670784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08003800) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08003800) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 247604) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD423287) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA08003800) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2018-08-08 |