| NPI | 1184009888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12155100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 66875) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 74112) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2024-08-14 |