| NPI | 1174789044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD438411) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0024676) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME165112) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09268200) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2024-01-02 |