| NPI | 1356517593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08883100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME153329) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 22124) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 109967) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2023-04-17 |