| NPI | 1255794525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD470704) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11561700) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME156637) | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2024-02-19 |