| NPI | 1356541320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08923500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 233431) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2016036713) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-07-12 |