| NPI | 1891940938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA07393900) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NJ 25MA070393900) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA07393900) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 216092) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2013-01-30 |