| NPI | 1245297100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ MA055183) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 171442) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME0066652) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G82093) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-08 |