| NPI | 1205312279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA12917600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12917600) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2026-03-04 |