| NPI | 1922202738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25mb06389400) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ 25mb06389400) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-02-02 |