| NPI | 1992013528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: PA MD453198) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: PA MD453198) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: PA MD453198) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NJ 25MA09579200) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: NJ 25MA09579200) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NJ 25MA09579200) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2016-08-19 |