NPI | 1326159443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA07640000) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA07640000) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 02440-1) | |
2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD428114) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2020-08-31 |