| NPI | 1952508087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25mb08234500) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MB08234500) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2014-10-06 |