| NPI | 1497755847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA06320100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06320100) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2012-04-20 |