| NPI | 1043274350 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09914200)  | 
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NJ 25MA09914200)  | 
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MO MD108645)  | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO MD108645)  | |
| Enumeration Date | 2006-04-13 | 
| Last Update Date | 2024-08-16 |