| NPI | 1457337826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME97699) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA045678) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA04567800) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2016-09-02 |