| NPI | 1982865200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MB08418700) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB08418700) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA OS014479) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 311141) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-02-28 |