| 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 |