| NPI | 1013597467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MB13043500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A23752) |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2026-06-30 |