| NPI | 1952342685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NY 214052) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 214052) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-07-05 |