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 |