| NPI | 1033400056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09868900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125057313) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2023-04-17 |