| NPI | 1346522554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 26757) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12320200) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-53568) | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2024-12-04 |