| NPI | 1366646879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 50637) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25IA12907000) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025024854) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX W0804) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036158130) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2026-03-24 |