| NPI | 1225525389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 84743) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 84743) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA12056900) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12056900) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA12056900) | |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2026-05-04 |