NPI | 1386134856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA12640200) |
Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: KY 59229) |
2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TX U9823) | |
2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: NJ 25MA12640200) | |
Enumeration Date | 2018-05-10 |
Last Update Date | 2025-06-30 |