| NPI | 1508081548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10689000) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 40856) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.207845) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-07-19 |