| NPI | 1467505131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA02590600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD014083E) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NJ 25MA02590600) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: PA MD014083E) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2015-06-25 |