| NPI | 1073556056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12088100) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036-084209) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-07-11 |