NPI | 1912498353 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA11832000) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A302322) |
208100000X Physical Medicine & Rehabilitation (Licence: NY 302322) | |
Enumeration Date | 2018-05-22 |
Last Update Date | 2024-09-05 |