| NPI | 1124465927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10190300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204568) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2022-09-27 |