NPI | 1013123587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA09844600) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD439255) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 242927) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09844600) | |
2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD439255) | |
Enumeration Date | 2007-05-14 |
Last Update Date | 2018-12-18 |