| NPI | 1922045194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA04520500) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ MA45205) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-01-30 |